Nearly 80% of people with PD have constipation, and this condition often predates the motor symptoms of Parkinson’s by several years. Prevotellaceae family of bacteria (Prevotella, Alloprevotella, Hallella, and Paraprevotella spp.), important in the synthesis of thiamine, folic acid, and the maintenance of an intestinal barrier against environmental toxins, was present at lower levels in the guts of people with PD. Enterobacteriaceae family (Escherichia, Yersinia, Klebsiella, Shigella, Proteus, Enterobacter, Serratia, Citrobacter, and other spp.) were found to be higher in people with PD with more severe postural instability and gait difficulty. Researchers believe the normal bacteria of the gut might affect the functioning of the gut nerves which could in turn affect the nerves of the brain. Alpha-synuclein, a protein that clumps in the brains of all people with PD, has been found in several other locations, including the nerves controlling the intestines. The question of whether the abnormal protein shows up in the gut neurons first, causing non-motor symptoms, and then later spreads to the brain to cause motor symptoms needs to be addressed. These findings may have implications not only for diagnosis but also for dietary adjustments or vitamin supplementation for management of PD in the future. The gut flora could also serve as biomarkers to diagnose and track the progression of PD.
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Scheperjans, Aho, V., Pereira, P., Koskinen, K., Paulin, L., Pekkonen, E., Haapaniemi, E., Kaakkola, S., Eerola-Rautio, J., Pohja, M., Kinnunen, E., Murros, K. and Auvinen, P. (2015). Gut microbiota are related to Parkinson's disease and clinical phenotype. Movement Disorders, 30(3) pp. 350–358. doi: 10.1002/mds.26069
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